This article was previously published on September 12, 2019 and has been updated with new information.
Benign paroxysmal postural vertigo (BPPV) is one of the most common forms of peripheral vertigo, which means it originates from a problem in your inner ear, not your brain.first,2 BPPV refers to a condition in which calcium carbonate crystals deposited in the labyrinth of your inner ear are disturbed and end up in your ear canal.
While your outer ear canal, eardrum, and middle ear are involved in the transmission and interpretation of sound, your inner ear is not directly involved in hearing. Instead, the organs in your inner ear act as a gyroscope that informs the brain about your body’s position in space and coordinates with the brain to balance your body as you move.3
The crystals disrupt the flow of fluids, thereby disrupting your balance organs, leading to dizziness – a feeling of movement or spinning even though you are standing still. As Medical News Today reported:4
“Moving the head can cause dizziness because the solid crystals respond to gravity. The following postures and head movements can cause dizziness in people with BPPV:
- Turning
- Lie on your head
- Roll on the bed
- Bow your head forward
- Tilt your head back”
In severe cases, it may be difficult for you to balance enough to perform everyday tasks. It may also be accompanied by other nausea, vomiting, abnormal eye movements, headache, sweating, ringing in the ears, double vision and/or lack of coordination.
Other causes of dizziness
In addition to BPPV, the result is misplaced crystal deposition, peripheral vertigo5 It can also be triggered by an abnormal production of fluid inside your inner ear, causing pressure. This is called Meniere’s disease.6
Inflammation (usually due to viral infection)7) in the maze of your inner ear8 (labyrinthitis) is another possibility that can cause dizziness. In this case, since the maze contains both balance and hearing organs, your hearing will also be affected.
Similar to labyrinthitis, vestibular neuritis refers to an inner ear infection that in this case affects the nerves that connect your inner ear and brain, thereby disrupting the flow of blood. trust the normal feeling.9
Another less common cause of peripheral vertigo is acoustic neuritis, which is when a non-malignant tumor develops in the cranial nerve of your inner ear. As the tumor grows, it pushes on nearby nerves, causing dizziness, hearing loss, headaches, and facial numbness.
Anxiety and stress can also cause dizziness, as the vestibular system (responsible for sensing your position in space) also interacts with brain regions involved in anxiety.ten
Dizziness can also be caused by damage to your central nervous system (CNS, which includes your brain and spinal cord), which is called central vertigo. Your CNS is responsible for controlling muscle movement and transmitting sensory stimuli to your brain. In central vertigo, damage or dysfunction in the cerebellum, the brain’s balance center, tends to be active.11
Common underlying causes of central vertigo include concussion or traumatic brain injury,twelfth The hit,13 multiple sclerosis, vestibular migraine,14 and tumors affecting your brain and/or spinal cord.
Diagnostic test for BPPV
Most cases of BPPV-related dizziness resolve on their own within a short period of time, but if the problem persists for days or is chronic, seek help from your primary care physician. Tests that can help diagnose BPPV include:15
- Dix-Hallpike test – While lying on your back, your doctor will rotate your head. If you have BPPV, this will make you dizzy.
- Electromyography – This test involves observing your eye movements under different conditions, such as when moving your head or looking at bright light.
- EEG – An EEG measures your brain activity and can be used to rule out a more serious neurological condition.
- MRI – An MRI scan may also be used to examine your head and ears to rule out a more serious condition.
If your doctor diagnoses you with BPPV, they may recommend physical therapy to shift crystal deposits in your inner ear to a position that won’t affect your balance.
There are several different bead repositioning procedures that can do this, including the Epley, Foster, Semont, and Brandt-Daroff manipulations.16 If you suspect you have BPPV, you can also try these home remedies for some relief.
How to Do Epley Maneuver to Treat BPPV
In this video, Dr. Christopher Chang explains how to perform the Epley maneuver and how it works to resolve BPPV-related dizziness. The summary is as follows:
- Lie on your back with a pillow under your shoulder blades, so that your head is tilted back 25 to 30 degrees. Tilt your head 45 degrees to whichever side causes dizziness. Stay in this position until the dizziness stops, usually about 30 to 60 seconds
- Turn the head half to the opposite side (90 degrees) without raising it. Wait another 30 to 60 seconds
- Next, turn your body to the side so that you are looking down, toward the floor, with your head turned 45 degrees to the horizontal. Wait 30 to 60 seconds
- Slowly sit up. Avoid standing until or unless dizziness has resolved
Research17 in the June 2019 edition of Clinical Therapeutics and Risk Management reviewed data from 359 patients treated in a Chinese clinic. The two main ways used are the Epley style and the “barbecue roll”.
The most common cause of BPPV involved the posterior semicircular canal (73.5%), followed by the transverse semicircular duct (22.5%) and involving the multiduct (3.3%). The seed repositioning operations solved 95.8% of posterior semicircular canal cases, 100% of transverse semicircular canals and 75% of multiductal cases.
How to Perform Nurturing Mobility
Some people find the Foster Half Somersault move easier to do because you don’t have to be in bed. In the video above, Chang explains how to do it. Here is a summary:
- Kneel on all fours, raise your head and look up at the ceiling for a few seconds
- Bend your chin toward your knees, so that the top of your head rests on the floor. Wait for the dizziness to stop, usually about 30 to 60 seconds
- Turn your head about 45 degrees in the direction causing the dizziness. Wait 30 to 60 seconds
- Keeping your head turned at a 45-degree angle, quickly raise it with all four legs so that your head is level with your back (tabletop position. Wait 30 to 60 seconds.
- With your head still tilted at a 45-degree angle to the affected side, quickly sit up. If necessary, repeat the sequence after a 15-minute break
You can also find instructions for another similar bead repositioning procedure, with drawings showing body position, on the Cleveland Clinic website.18
Other alternative treatments for BPPV
BPPV that does not respond to repositioning maneuvers can be treated with betahistine. According to the International Tinnitus Journal,19 betahistine “provides short-term relief of acute symptoms associated with BPPV by improving microcirculation in the maze…”
An all-natural alternative is to take ginkgo biloba. This Chinese herb is often used to treat dizziness because it helps regulate blood flow to your brain. According to one study,20 ginkgo biloba is just as effective as betahistine.
Another alternative is the use of ginger partition acupuncture, which requires a visit to a qualified acupuncturist. It consists of placing a thin slice of raw ginger on the skin (at the appropriate acupuncture point) and then placing a piece of burning moxa on top.
In one study,21 The acupuncture point ginger zonal massage method known as Tinggong (SI 19) has been found to more effectively improve vertigo than granular repositioning procedures alone.
Conventional treatments for other forms of vertigo
If caused by an inner ear infection, treatment is needed to resolve the infection. Since most inner ear infections are caused by viruses and not bacteria, antibiotics are generally not recommended because they do not work on viruses. However, some natural remedies may be helpful, such as garlic, coconut oil or onions. For vertigo associated with a traumatic brain injury, you will need to consider treatment for a concussion.
Naturally, in the event that your dizziness is caused by a more serious chronic illness, such as MS or a tumor, treatment will need to address those as well. Ditto for stress-related anxiety and/or dizziness, in which case cognitive-behavioral therapy may be helpful.22
If your dizziness is caused by a vestibular or balance disorder that originates in your central nervous system, vestibular rehabilitation therapy may be recommended. As explained by Vestibular.org:23
“[A]The vestibular system is damaged, people may feel better and function may return through compensation. This happens because the brain learns to use other senses (sight and hearing, i.e. bodily sensations) to replace the missing vestibular system…
For many people, compensation occurs spontaneously over time, but for those whose symptoms do not subside and continue to have difficulty returning to daily activities, VRT can help with recovery by: compensation promotion. “
Other alternative home treatments for vertigo
In addition to the repositioning maneuvers discussed above, other home treatment strategies that may provide temporary or occasional relief of dizziness include:
• Stay hydrated – Even mild dehydration can cause dizziness, so make sure to stay hydrated by drinking enough clean, pure water.
• Sleep with your head slightly up – When you wake up, move slowly out of bed and sit on the edge of the bed for a minute or two before standing.24
• Making sure you get enough magnesium can help prevent or reduce dizziness. According to Vertigotreatment.org, vestibular disorders are rare in “those parts of the world where magnesium is present in the diet in large amounts.”25
You can also find more information about the “vertigo diet” used in the treatment of Meniere’s disease and vestibular migraine on vertigotreatment.org.26
• Try these folk remedies – Ginger, a folk remedy with a long history of curing nausea and motion sickness, can also help with dizziness. Another option is to make apple cider vinegar and honey. Just mix two parts raw honey with one part apple cider vinegar. Stir and drink.
• Essential Oils Therapy – Essential oils known to address the nausea and dizziness associated with vertigo include peppermint, ginger, lavender, and shiso.27
